Evaluating essential health packages from a human rights perspective

Chapman, Audrey R.; Forman, Lisa; Lamprea, Everaldo

doi:10.1080/14754835.2015.1107828

Cited by 27 publications

(8 citation statements)

References 11 publications

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“…4 The process of prioritizing essential health services is value-laden, heavily dependent on local context, and often tied to larger social movements. 48 In some instances, essential packages have been criticized for service delivery shortcomings. 49 While EHSPs carry much promise, it is yet unclear the extent to which they are realized in everyday practice in LMICs.…”

Section: Discussionmentioning

confidence: 99%

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Aligning priorities in Ethiopian health finance: How do the essential health services package and health benefit plans compare?

Koon

Wright

Ageze

et al. 2021

Health Planning & Management

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Priority setting is a key function of health systems in lowand middle-income countries that seek to achieve universal health coverage. Essential health services packages (EHSPs) and health benefit plans are two types of instruments used in setting health care priorities. Both instruments exist in Ethiopia, but little is known about how they are aligned. To gain insights into the evolution, purpose, policy objectives, and governance of the EHSP, community-based health insurance (CBHI), and social health insurance (SHI) in Ethiopia, we conducted a case study. This included a desk review of relevant documents as well as qualitative analysis of key informant interviews conducted with 15 leading health finance experts in Addis Ababa. Interviewees understood the EHSP to be a key priority-setting instrument in the country by coordinating the activities of health system stakeholders, and guaranteeing the right of citizens to a basic level of care. Community-based health insurance and SHI were described as mechanisms for the government to expand health coverage and provide financial protection. Interviewees acknowledged that Ethiopia had drawn on the experience of other countries when designing health benefit plans, but contrasted Ethiopia's experience with that of other countries. We found that in Ethiopia, the EHSP, CBHI, and SHI are not explicitly aligned. We propose that EHSPs play an important role in early stages of health systems development.

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Section: Discussionmentioning

confidence: 99%

“…This finding is consistent with the literature on essential packages. 46,48,50 The Ethiopian experience suggests that the utility of essential packages of health services may change as health systems evolve. Some would argue that this should be celebrated as a beneficial feature of a socially contingent priority-setting mechanism.…”

Section: Discussionmentioning

confidence: 99%

Aligning priorities in Ethiopian health finance: How do the essential health services package and health benefit plans compare?

Koon

Wright

Ageze

et al. 2021

Health Planning & Management

View full text Add to dashboard Cite

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“…The CESCR’s interpretation affirms ‘core obligations’ as the nucleus of the right to health [ 16 , 37 ]. Core obligations are fundamental basic minimums that must be realised to give meaning to the right to health; they serve as the foundation on which other aspects of the right are built [ 38 , 39 ]. Additionally, the CESCR states that ideologically-based policies or practices, such as the refusal to provide services based on conscience, must not be a barrier to accessing services (para.…”

Section: Discussionmentioning

confidence: 99%

Realising the right to sexual and reproductive health: access to essential medicines for medical abortion as a core obligation

Perehudoff

Pizzarossa

Stekelenburg

2018

BMC Int Health Hum Rights

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BackgroundWHO has a pivotal role to play as the leading international agency promoting good practices in health and human rights. In 2005, mifepristone and misoprostol were added to WHO’s Model List of Essential Medicines for combined use to terminate unwanted pregnancies. However, these drugs were considered ‘complementary’ and qualified for use when in line with national legislation and where ‘culturally acceptable’.DiscussionThis article argues that these qualifications, while perhaps appropriate at the time, must now be removed. First, compelling medical evidence justifies their reclassification as a ‘core’ essential medicine. Second, continuing to subjugate essential medicines for medical abortion to domestic law and cultural practices is incoherent with today’s human rights standards in which universal access to these medicines is an inextricable part of the right to sexual and reproductive health, which should be supported and realised through domestic legislation.ConclusionThis article shows that removing such limitations will align WHO’s Model List of Essential Medicines with the mounting scientific evidence, human rights standards, and its own more recently developed policy guidance. This measure will send a strong normative message to governments that these medicines should be readily available in a functioning and human-rights-abiding health system.

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“…Human rights principles (i.e. entitlements, State obligations, participation and accountability) create an enabling environment for patients to claim their rights and hold their governments accountable; therefore, these principles are also important aspects of legislation (Motta Ferraz, 2011; Chapman, Forman and Lamprea, 2017; Yamin and Maleche, 2017). Yet, previous studies of legal or policy interventions for medicines often source data from systematic literature reviews, websites of international organizations and/or key informants, rather than the laws or policies themselves (Vialle-Valentin et al.…”

Section: Introductionmentioning

confidence: 99%

Legislating for universal access to medicines: a rights-based cross-national comparison of UHC laws in 16 countries

Perehudoff

Alexandrov

Hogerzeil

2019

Health Policy and Planning

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Universal health coverage (UHC) aims to ensure that all people have access to health services including essential medicines without risking financial hardship. Yet, in many low- and middle-income countries (LMICs) inadequate UHC fails to ensure universal access to medicines and protect the poor and vulnerable against catastrophic spending in the event of illness. A human rights approach to essential medicines in national UHC legislation could remedy these inequities. This study identifies and compares legal texts from national UHC legislation that promote universal access to medicines in the legislation of 16 mostly LMICs: Algeria, Chile, Colombia, Ghana, Indonesia, Jordan, Mexico, Morocco, Nigeria, Philippines, Rwanda, South Africa, Tanzania, Turkey, Tunisia and Uruguay. The assessment tool was developed based on WHO’s policy guidelines for essential medicines and international human rights law; it consists of 12 principles in three domains: legal rights and obligations, good governance, and technical implementation. Relevant legislation was identified, mapped, collected and independently assessed by multi-disciplinary, multi-lingual teams. Legal rights and State obligations toward medicines are frequently codified in UHC law, while most good governance principles are less common. Some technical implementation principles are frequently embedded in national UHC law (i.e. pooled user contributions and financial coverage for the vulnerable), while others are infrequent (i.e. sufficient government financing) to almost absent (i.e. seeking international assistance and cooperation). Generally, upper-middle and high-income countries tended to embed explicit rights and obligations with clear boundaries, and universal mechanisms for accountability and redress in domestic law while less affluent countries took different approaches. This research presents national law makers with both a checklist and a wish list for legal reform for access to medicines, as well as examples of legal texts. It may support goal 7 of the WHO Medicines & Health Products Strategic Programme 2016–30 to develop model legislation for medicines reimbursement.

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Evaluating essential health packages from a human rights perspective

Cited by 27 publications

References 11 publications

Aligning priorities in Ethiopian health finance: How do the essential health services package and health benefit plans compare?

Aligning priorities in Ethiopian health finance: How do the essential health services package and health benefit plans compare?

Realising the right to sexual and reproductive health: access to essential medicines for medical abortion as a core obligation

Legislating for universal access to medicines: a rights-based cross-national comparison of UHC laws in 16 countries

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